MNS 2024
Child Health Nursing (Pediatrics)
Easy
Polio vaccine is contraindicated in a child suffering from:
Appeared in: MNS 2024
Explanation
- Malignancies, such as leukemia and lymphoma, and their treatments (e.g., chemotherapy) cause severe immunosuppression.
- The Oral Polio Vaccine (OPV) is a live attenuated vaccine, meaning it contains a weakened form of the live virus.
- Administering a live vaccine to an immunocompromised child can lead to the virus replicating unchecked, causing the very disease it is meant to prevent (vaccine-associated paralytic poliomyelitis or VAPP).
- Therefore, malignancy is an absolute contraindication for the administration of OPV.
Why Other Options Were Wrong
- Option A: Mild to moderate diarrhea is not a contraindication for OPV. It is a common childhood illness.
- Option B: Conjunctivitis is a minor, localized eye infection. It does not cause systemic immunosuppression and is not a contraindication for vaccination.
- Option D: HIV infection is a relative, not absolute, contraindication. The decision depends on the child's immune status.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Contraindications for live attenuated vaccines, specifically the Oral Polio Vaccine (OPV) as background academic context rather than a clinical decision trigger.
- A nurse's primary responsibility before administering any vaccine, especially a live one, is to perform a thorough pre-vaccination screening for contraindications.
- This includes asking about the child's health history, specifically any known immune system problems, cancer, or use of immunosuppressive medications like steroids.
- Failure to identify an immunocompromised child before giving a live vaccine can lead to life-threatening complications and is a serious patient safety issue.
How to Approach the Question
- First, identify the core of the question: it asks for a contraindication to the polio vaccine.
- Recognize that the polio vaccine comes in two forms: OPV (live) and IPV (killed). In the context of contraindications related to immunity, the question is implicitly referring to the live vaccine (OPV), which is standard in many national immunization schedules.
- Analyze the options based on the principle that live vaccines are dangerous for immunocompromised individuals.
- Evaluate each option: 'Diarrhea' and 'Conjunctivitis' are minor illnesses and unlikely to be absolute contraindications.
- Compare 'Malignancy' and 'HIV infection'. Both can cause immunosuppression. However, malignancy and its treatment (chemotherapy) cause profound and definite immunosuppression, making it an absolute contraindication.
- Recall that the contraindication for HIV is nuanced (symptomatic vs. asymptomatic). Therefore, malignancy is the most definitive and correct contraindication among the choices.
Concept Tested & Keywords
- Concept Tested: Contraindications for live attenuated vaccines, specifically the Oral Polio Vaccine (OPV).
- Stem keywords: Polio vaccine, contraindicated, child
- Lead-in keywords: suffering from
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Question ID
QBrM-ouOXpQpEv5rqYEdO_
Reference Book
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 215-217
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 58-60
Practise the full MNS 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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